Report of 27 June 2010

Hello from the Carmel library -

From the New England Journal of Medicine, 10 June 2010: "Current data suggest that each year, at least 1.6 million traffic accidents (28% of all crashes) in the United States are caused by drivers talking on cell phones or texting. ... moreover, using a hands-free device does not make talking on the phone any safer. .... driving while distracted is roughly equivalent to driving drunk ..."

Driving and talking on the cell phone is illegal in India; first offence causes a fine, I think, and second offence causes a permanent loss of the driver's licence.

Trust all are well. I am fine and just finished my first full-time week of work. It was nice; any day that one can work is a good day, and I look forward to working until I am 90. If that is my life span. We had a male patient come in with nipple pain, and I have sent him for a mammogram; breast cancer in women is slower to spread due to the abundance of fat in the breast that the cancer cells must traverse before they hit the chest wall, and in men, the cancer cells hit the chest wall directly and spread rapidly. Thus, breast cancer in men is much more aggressive. I also had a patient come in with shoulder pain; as I entered the exam room, there was a veritable entourage in there - a total of 3 women, and the room reeked of cigarette smoke. The patient told me her regular doctor had done nothing for her, a train of thought I did not encourage. She told me of her shoulder pain, and I examined her and have sent her for an xray. She also told me of "nerves," which I am ill-equipped to handle, and so I suggested that she see a psychiatrist, which she was willing to do. I told her of the part she must play in healing, which is to stop smoking. Her mother and grandmother were in the room, the mother mentioned a history of osteoporosis in herself, and I suggested she stop smoking also. She seemed flabbergasted to hear that smoking and osteoporosis are connected; indeed, they are.

If the patient is young, I don't enjoy umpteen related people in the exam room, unless absolutely necessary. As evidenced above, these visitors end up talking about their own health issues, or irrelevant matters, or bicker, and the visit ends up taking off elsewhere. My older patients are very welcome to bring relatives, as I consider dissemination of information to the family paramount in such folks' care, and sometimes I have to rely on relatives for an update on the patient (a "history").

Some fine times this week: former colleagues from Medical Education at St. V, Ruth Ranalletta, Tami Horkay and Boni Hypes, and I got together for dinner at Ruth's home. She grilled burgers and portobello mushrooms, and all of us talked, ate, laughed. I had 1/3 of a margarita, plenty of food and great conversation, and the evening was pleasant and comfortable. I don't recall when all of us stopped talking and laughing, but we did have to leave as we had to work the next day; I left rejuvenated in body and spirit, and grateful for the presence of these folks in my life. Kris and Gabe, my current hosts, had some time to chat this week and that was wonderful; their perspective on life, work, family and much else is pretty fascinating and we talked and laughed also. They have finished a busy 2 weeks very successfully, and I was very happy for this lovely couple.

I spoke to my Dad today, and he had been to Bangalore for a talk, plus had visited a widower friend. Both men lost their wives on 21 Feb 2010 and 22 Feb 2010 (my mother), and had much to talk about. My father considers himself blessed that all of us check in on him, and expressed that thought clearly; it was nice. I also talked to the 3 Weiss men and that was hilarious; Scott had had to referee the umpteenth fight, and was worn out, then the boys came on the phone and professed complete consideration of their father. I laughed and laughed. I imagine other mothers of teenage sons who live to irritate their fathers can relate.

Movie-watching goes on and I saw "Knight and Day" yesterday. It was okay; the luminous Paul Dano only had a bit part, but the movie was quite entertaining.

Unw -

R

Report of 20 June 2010

Hello from the Carmel library -

Books, books, books - free. Such therapy.

Happy Father's Day to all! This year, more than ever, I am aware of the contributions a father makes, and I hope all the phenomenal fathers on this reading list have a great day. I talked to the 2 fathers in my life - Scott and my father - and wished them. FD is not celebrated in India, and my father thanked me for the wishes. Naren and Navin had made Scott breakfast, his present having to be left behind here ("My presents are here in Chennai," said Scott), and Scott said he had enjoyed the day, which I was happy about. Naren reached home safely, sans "Random Security Checks," and I am relieved. There was a time when air travel was not the worrisome mess it is now.

Naren got safely off the ground at O'Hare - several pounds lighter as his baggage was overweight with candy and deos and junk that all of us had bought. So things had to be unloaded into the trash bags that I had taken along, and I brought them back with me. As I waited for Naren's flight to take off, I told a young lady that I had sat next to that I was not normally embarrassed by much, but having to wheel a cart around with 2 trash bags on it was truly a new, somewhat awkward experience.

I am now at the warm and loving home of Kris Rea and Gabe Soukup, and their daughters Isabella and Rosalia. My father was a bit concerned at the new location, asking if this was by choice or whether I'd been deported by the Tabers. :). It is by choice, wanting to spread out the pain of being a houseguest over several households. Naren and I had stopped by this house on Tuesday, to drop off some of my things, and Naren enjoyed the time he spent with the little girls. He talked of little else on the ride back. The home and people are truly lovely. There are more trees in the Rea-Soukup backyard than our entire Chennai street, and I have spent every evening sitting out, reading. It is beautiful, and relaxing.

The practice got busier, to my delight. It is nice to be busy, the day flies by, and we have taken care of many. The support staff at the clinic vary their pace of work accordingly and are customarily efficient, which is wonderful, and I appreciated "being run" by someone who put the patients in quickly, so that I could then do my job. One of our colleagues has been away in China to adopt a baby girl, and we have seen his patients, which has added to the nice busy-ness. One of the patients had called in saying her blood sugar was 47, she had been nauseated and unable to eat anything to get her sugar up; I did not want to field this issue by phone and asked that the lady be brought in for an appointment. I saw her on Friday: she was pale and pukey. I went through a very detailed history, saw that she'd had prior stomach surgeries, and asked for a cat scan (CT). It showed that she might have a partial bowel obstruction, and I have referred her to a surgeon. I phoned her soon after the CT results came, shared them, and asked how she was: she had been following my suggestion of small,bland meals, and the crackers and Sprite were staying down for the time being. I was pleased. The appointment with the surgeon is for tomorrow, and I hope the lady does well.

It is nice to work in a country where I can order a CT scan without worrying about its effect on wallets.

Naren and I finished some last-minute shopping before he left, and ate some junk food. We talked for a while over the meal. The boys are very opinionated (where do they get that?!), and I enjoy their opinions immensely. At one time, when we had to discipline one of them in India, he said, "I understand why you have to do this, but I don't like it." Naren and I saw "Harry Brown," the story of a vigilante, and I found it well-acted but unrealistic; Naren then mentioned a similar movie in Hindi, "A Wednesday," which was very slickly done and was completely believable. So we discussed that, and other things, and then it was time to return to the friendly Taber home (where we were until Naren returned to India), and watch the basketball game. The rats Celtics lost to the Lakers, and I was disappointed with that outcome.

My sister, Anu, was in the U.S. last week for some important meetings. She is a researcher of considerable caliber, and is in trials with Johns Hopkins, and researchers in the U.K. and other countries. We did not manage to meet, or speak on the phone, but caught up over email. She hoped that I did not miss my family too much. There was a very needy email from Chennai right around the time Naren left: it was something that could have been handled easily right in Chennai, but for some reason, I was roped in. Tell the wife and mother, she'll handle it. Que? Enna? Quoi? Entha? No, no, no - wife and mother is elsewhere, taking care of her own affairs and patients, and other capable individuals can handle the Chennai issue. As always, the cosmos righted itself, and I was soothed that I had really no occasion to miss the family too much. Let the workouts begin, let the movie-watching and eating vats of fruit continue, let the business of catching up with U.S. friends start. In a couple of months, all of us (Weisses) will feel the need for each other and then mindsets will change.

Unw -

R

Report of 13 June 2010

Hello from the Tabers' warm, friendly home -

It is nice to sit down, isn't it, and not drive around madly. We've had to catch up on movies and shopping and farewells, and I am happy to have a Sunday at home. The room I have here is wonderfully comfortable, and a perfect sleeping environment. The Tabers' uncomplicated, genuine hospitality is always a treat.

Work has been good, and St. V has been kind about letting me work part-time while the family is here. The patients are nice, and chatty, and not venomous. There is a young man who has been evaluated for bariatric (weight loss) surgery, and is sincere about losing weight. He exercises more now, and I am grateful for having attended the conference in Toronto that told us three 10-minute sessions of exercise do equal one 30-minute session. The thinking previously was always 30 minutes of continuous exercise 5 days a week. As I commended this young man for his choices, including a salad daily, I paused to consider his influences: he weighs 600 lbs, and had to drop out of school to care for his father, his mother having left when he was very small. His 16 yo sister lives with a 50 yo boyfriend, and I felt sorry for the young people, that they had nobody to teach them right or wrong, whether in diet or in life choices. The young man comes to the doctor regularly now, and I am very pleased; we will get him healthy yet.

My mother seems more and more wonderful daily.

Scott and Navin reached home safely: a great relief in today's air travel world. Naren and I spent a therapeutic week alone here; the Tabers were away on vacation and it was nice to have a whole house to ourselves. We watched the NBA playoffs, unfortunately having to forego an early morning workout the next day. We watched a lot of movies at home, including one that Naren recommended: "City of God." One day, we made brownies and Naren licked the pan afterwards; whether 9 or 19, that pan holds a certain allure, does it not. We also saw "Get him to the Greek," "The Karate Kid" and "The A-Team." TKK was very good, with outstanding performances by Jaden Smith and Jackie Chan, and a very respectful depiction of another culture.

We were at St. V's residency graduation on Friday, and I enjoyed the meaningful speech that the keynote speaker, Dr. Pat Healey, gave. I like this event a lot, because senior physicians often talk about the meaning of medicine as it applies to them, which I enjoy immensely. Naren was bored witless with all the socialising, and Dr. Robert Love was kind enough to sit near us to engage him in meaningful conversation; I appreciated this greatly.

I had to go to the dentist with an emergency, and my nice colleague Beth's husband, Dr. Scott Prusinski, treated me for free. Over all my protestations. His extremely professional and competent manner, and his sense of humor, made the visit very satisfying, and I consider myself very privileged to have such kindnesses come my way.

We took Menfil, the resident visiting from Guatemala, with us yesterday to the farm, and all had a nice time. Scott's cousin Deb was down with her sons, and that was good fun. A most rejuvenating day was spent gabbing and eating and laughing with some great folks. Menfil's English is good enough to sustain many a conversation, our Spanish regretfully isn't. On our way back, we got caught in a severe rainstorm, and lightning hit a post about 15 feet away from us; there was a blinding flash which lasted several seconds, sort of like a fluorescent light being turned on, and it was very cool. Only later did I realise that we were lucky to escape harm. It is amazing how God protects us in all kinds of situations.

I spoke to my Dad, and he mentioned having talked at length to Scott. "He talks sense, Renu," he said, and I started laughing. As he wondered why, I said that Scott was a sensible and pragmatic and affectionate sort; when my father had mentioned being lonely, Scott had invited him again to come and live with us. My father has declined again, but he knows the welcome is there, and that counts for something. I hope Scott's and my epitaphs read "Got along with the in-laws;" that is a great gift for me.

Unw -

R

Report of 7 June '10

Hello from Indiana -

Before I forget, our single friend, Craig, wanted me to tell everyone that he was single, dashing, well-dressed and liked long walks on the beach and short flings.

The week has been okay. It has been nice to have my family here with me. Scott and Navin reached Chennai safely, minus "random security checks," as Scott put it. They were in the land of high heat, and having to take multiple showers. Navin is combating jet lag with a vengeance, and has been asleep early many times that I've called. Resuming school and work routines has happened, as has doling out the American goodies bought for others, which many folks look forward to.

Naren spent the rest of last week with his grandmother, grand-aunt and -uncle, and I got him yesterday. Spending a night and morning with the in-laws was fun, and we talked a ton, which is always very therapeutic. Naren has some shopping to do yet, and visiting up here. We took Menfil, a resident visiting from Guatemala, out to shop and dinner yesterday, and that was great fun; Menfil is 27, more my kids' age than mine (as much as I think the residents and med students are getting younger every year, there is also the realisation that I am getting older), with a very good sense of humor, and much laughter ensued in the course of the evening. It is always, always good to laugh.

The patients have been wonderful. One of the ladies this morning, an 84 year old with foot pain, flashed me a very "Mom" look as I poked at the exact source of the pain; it was so filled with annoyance, due to the elicited pain and perhaps due to me as well, that I burst out laughing. Her daughter and she joined in, and I mentioned that all us Moms must perfect that look. I have sent her for an xray, and am hopeful that Home Health can look in on her. Another patient with an umbilical hernia came today complaining of pain, and we talked a bit; he is not very old, but has a son married to a woman in Japan, living there and not quite likely to move back. That reminded me a great deal of Scott, and we talked for a bit. It was nice to chat. The patient's abdominal cat scan (CT) came back showing an inflamed hernia, and I have referred the patient to General Surgery.

I saw "Sex and the City part 2." Even bawdy humor can be funny, and I was prepared to accept this movie with its unique cultural slant; however, it tried to mix too many things up - marriage, single life, complexities of relationships and then threw in 4 "trampy" women visiting the Middle East for good measure. It was not enjoyable, with extremely shoddy acting, and I nearly asked for my money back. Naren and I saw "The Ghost Writer" at the $1 cinema, and I contrasted Kim Cattrall's fine performance there with her suboptimal turn in "SATC."

We were delighted that the Celtics won. Great game, including Ray Allen's record of 8 3-pointers. I did not see the French Open, but am happy Rafa won.

Olivia gave me quite a few clothes from her closet, and I have worn the clothes, and felt singularly well-dressed - completely outfitted in "Olivia Fondoble," as I always say. It is lovely to get a nice, new wardrobe annually, without having to go through onerous shopping.

My gentle husband talked to my Dad and said he was feeling chatty. It is nice to get along with one's in-laws, and extremely nice to have one's spouse get along with one's family. Naren has mentioned that I seem to say many things my mother used to, and refer to her a lot, and I imagine that will continue for a while.

Unw -

R

Report of 2 June 2010

Hello from Indiana -

It has been a frenetic, but fun, few days. Normal routine went for a toss, as we visited relatives and friends, ate, ate, ate and accommodated the men's shopping.

Maryam Massoumi, her husband Ali, and kids Rustom and Golbarg had some other friends and us over for wonderful Irani food. It was a great evening, with Maryam and Ali's all-encompassing hospitality, good food and lovely company, and a memorable time was had. The kids totally enjoyed romping with Rustom and Golbarg. We stopped by the Simons' for a second dessert, and the boys caught up with childhood friends, Miranda and Morgan, which everyone appears to have enjoyed. It is always a treat to see all of them, and the sweet, generous Marybeth Simon even sent dessert home with us.

We spent Friday hanging out, eating b'fast at a nice restaurant where the all-you-can-eat pancakes were huge and Navin had *one*; Scott said the next time, Navin could order the "All you can eat pancake." We saw "Prince of Persia" and "Shrek," enjoyable for the men's company. There was little casting accuracy in PoP; surely there are actors of Middle Eastern descent who can play the roles? And when did tank tops make their way into battle? Mr. Gyllenhaal's mighty muscles had to be accommodated, I guess.

We spent a day down at the in-laws' farm, helping the vet with cow and calf maintenance: shots, ear tags and castration. It was expected to last 2 hours, given vagaries of cow and calf moods, but finished in a little over 1 hour. The vet was appreciative of all the assistance: there were about 10 helping (some in closer roles than others). After that, my mother-in-law provided an ice cream cake for Navin to cut, and I can think of nothing better than to spend a b'day with relatives and eat ice cream cake for b'fast. We stopped by Scott's grandparents' nursing home to say a quick bye, and the folks were so happy to see us that we extended the visit by a lot longer and stayed for lunch. Scott's grandfather's snide observations had the boys laughing non-stop. We got back to Indy, saw "How to train your dragon" by Navin's request (it was very good) and then caught up with Shilpa, Ravi, Keerthi and Surya Mallur, which was very nice, in their lovely new house.

On Sunday, John Sparzo took our sons to the Indy 500 and Glenn Fondoble, my friend Olivia's Dad, took Olivia, Scott and me. This was the first race for the Weisses, and the spectacle was impressive: the speeds, strategies, female drivers, unpredictability, all of it. Olivia and Glenn are pros, and we benefited enormously from their expertise, and thoroughly enjoyed their company, too. Not much conversation went on, of course, due to the ambient din and need for earplugs. Glenn was smart enough to choose the family section in the infield, which had trees, and I spent a grand afternoon in shade, watching magnificent machines and expert drivers handle them. A fight broke out among fans on the road in front of us, with punches being thrown and blood being drawn, reinforcing my conclusion that excessive alcohol use certainly hampers one's judgement in more than 1 way. This did not take away from the event, or from getting together with the Fondobles.

We got together with the Sparzos, Carolyn and other friends for dinner after the race and it was great. So much conversation flowing, laughter, great humor, and a welcome to all. Mandy Sparzo made the food and it was delicious. All of us had a fun time. We spent Monday with the Tabers, packing, and Melinda Taber came down from Ball State to visit, which was lovely. Mark Taber made a spectacular Memorial Day meal, and all of us ate to bursting, and had a scintillating conversation around the dinner table, full of opinions and news and chitchat.

Naren and I dropped Scott and Navin in O'Hare yesterday, and drove back, singing along with the classic rock stations. If 1 June has rolled around, 1 Sept cannot be far away.

The patients have been fabulous, too. One of them is an 89 yo, delightful lady, who'd inadvertently fallen asleep with a pot of beans on the stove, and awakened to find them burning. I had asked for home health help for her, and the good folks had helped Ms. X with her bath and exercises. During the visit in our clinic, Ms. X's daughters looked at me as though I'd worked a miracle; I had not, I had merely used the resources so wonderfully available here, located by our efficient and fine front office staff. It is nice to link people and help so easily. The older patient populace is a treat, with their life experiences, classic humor and gentle acceptance of all that life dishes out.

I talked to my Dad today, and he was extremely loquacious. Our cook - shunned, maligned and abused by her parents - got married today with the assistance of a bunch of people. She is a sweet young lady, and I wish her well; my Dad signed as her guardian. It was nice to talk to him.

Unw -

R